Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.21 / $40.21 / $40.21	Facility	26	$40.21	$40.21	$40.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.98 / $133.56 / $197.76	Professional		$95.98	$133.56	$197.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.08 / $43.18 / $60.61	Professional	26	$35.08	$43.18	$60.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.10 / $84.40 / $131.60	Professional	TC	$56.10	$84.40	$131.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.89 / $44.89 / $44.89	Facility	26	$44.89	$44.89	$44.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.58 / $146.08 / $257.43	Professional		$88.58	$146.08	$257.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $53.46 / $94.06	Professional	26	$28.84	$53.46	$94.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.42 / $92.88 / $178.10	Professional	TC	$60.42	$92.88	$178.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $107.00 / $263.41	Professional		$60.00	$107.00	$263.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.65 / $61.27 / $78.66	Professional	26	$47.65	$61.27	$78.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.61 / $180.16 / $233.41	Professional	TC	$136.61	$180.16	$233.41
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $103.47 / $177.11	Professional		$78.94	$103.47	$177.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $41.12 / $92.86	Professional	26	$33.97	$41.12	$92.86
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.42 / $62.35 / $128.93	Professional	TC	$50.42	$62.35	$128.93
United Facility/Professional Professional Modifier Low / Median / High Price $78.56 / $106.21 / $199.08	Professional		$78.56	$106.21	$199.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $44.03 / $80.12	Professional	26	$25.57	$44.03	$80.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.30 / $69.80 / $124.98	Professional	TC	$51.30	$69.80	$124.98